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NPI Code Detail

MEDICARE: DOROTHY CLAYTON COBIA

MEDICARE: DOROTHY CLAYTON COBIA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1962994764
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOROTHY CLAYTON COBIA
Provider Business Mailing Address
First Line : 186 E 1800 N
Second Line :
City : NORTH LOGAN
State : UT
Zip : 84341-2019
Country : US
Telephone Number : 435-213-3062
Fax Number :
Provider Business Practice Location Address
First Line : 186 E 1800 N
Second Line :
City : NORTH LOGAN
State : UT
Zip : 84341-2019
Country : US
Telephone Number : 435-213-3062
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2018
Last Update Date : 06/06/2018

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Directions to “ DOROTHY CLAYTON COBIA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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